The Eight Basic Qualities in All Personality Disorders

New research identifies eight interpersonal qualities in personality disorders.

From the earliest attempts by psychiatrists to diagnose longstanding deficits in adaptive functioning known as personality disorders to the most recent revision of the Diagnostic and Statistical Manual (DSM) in 2013, there has been confusion and controversy: How many of these disorders are there, how distinct are they from one another, do they show stability over time, and, importantly, can people who have them be cured?

Some disorders seem to provide sources of endless fascination to professionals and laypersons alike, such as narcissistic, antisocial, and borderline personality disorders. Each term has become part of popular parlance, even as their exact meanings become blurred and potentially distorted with each passing year.

The situation is not aided by the fact that psychiatrists and psychologists are at odds over whether there are, in fact, distinct personality disorders, or whether they rest on one or more continuums or dimensions. The old “Axis II” of the previous DSM put the disorders onto a separate plane from other psychological conditions that, in contrast, were regarded as true “diseases” that could be “cured.” Axis II, by contrast, was a part of the fabric of the individual’s psyche that could not be excised.

In a new version of an old approach to personality disorders as reflecting “styles” rather than stable disorders, University of Minnesota psychologist Sylvia Wilson and colleagues (2017) took the perspective of interpersonal theory to examine the interpersonal styles associated with each personality disorder. As they note, “Interpersonal style is defined by one’s characteristic approach to interpersonal situations and relationships” (p. 679). It includes the attitudes you have toward relationships, your goals in your relationships, how you interpret what happens in your relationships, the way you behave, and the way you interpret the behaviors of others. This all-inclusive concept, further, determines the quality of essentially all of your relationships, from those closest to you to the ones you interact with on a more formal basis.

You can detect an individual’s interpersonal style almost immediately upon meeting: Is this a person who seems friendly, easygoing, and amiable? Or do you pick up the vibes of someone who is suspicious, closed-minded, and cold? It’s often easy to spot someone who seems just a bit “too” friendly and whom you discover to be insincere or possibly unaware of boundaries. The idea of interpersonal style would seem to fit well with the personality disorder framework, because so much of what can go awry in personality involves relationships with others.

The theoretical underpinnings of interpersonal style fall into an approach popular in the mid-20th century postulating that “all interpersonal interactions reflect attempts to establish and maintain self-esteem or avoid anxiety” (p. 679). According to this view, you’re constantly trying to feel good about yourself in your relationships, because to recognize weakness would make you feel anxious. At some level, the theory proposes, we’re always searching for approval and validation.

Moving on to the content of the interpersonal theory, Wilson and her colleagues propose that all personality traits can be cataloged on the dimensions of agency (ranging from domination to submissiveness) and communion (ranging from warmth to coldness). These dimensions form a “circumplex,” or a circle with two dimensions that, in turn, can be divided into eight sections, like the slices of a pie. At the extreme end of dominance is autocratic, and at the extreme end of the cooperative dimension, you find the trait of being overly nurturant. In between these two ends is the trait of intrusiveness. The closer you get to the extreme ends of any dimension, the less desirable a trait becomes, as shown with warmth. You can be, according to this model, too warm.

The eight traits identified in this manner are as follows: domineering, vindictive, cold, socially avoidant, nonassertive, exploitable, overly nurturant, and intrusive. Personality measures based on the circumplex model have, Wilson and collaborators claim, considerable validity and have been used in a wide range of applications. Using the research method known as meta-analysis in which questions are addressed across a large number of studies, the authors screened nearly 4,800 papers examining interpersonal relationships across personality disorders. They ended up with a selection of 127 studies conducted over a 20-year period providing data on the eight personality traits defined by the circumplex model associated with each personality disorder. The authors conducted 120 separate analyses, which also included indicators of interpersonal style and functioning in interpersonal area domains, including family, peers, parent-child, and romantic partner. This rigorous approach yielded distinct interpersonal style profiles for each of the 10 major personality disorders, taking into account, as well, sex, age, and type of sample (clinical or non-clinical). Some of the analyses included as many as 13,000 individuals.

The extensive results provide profiles useful not only classification, but also for understanding how people within each of the disorders approach their relationships. For people in relationships with such individuals, it’s a framework that could help you understand them in more depth.

With this in mind, let’s examine the main interpersonal traits for each disorder:

Paranoid. Vindictive and cold stand out as the two predominant themes. To a lesser extent, people with this personality disorder are also intrusive.

Schizoid. Coldness with a combination of social avoidance form the main traits for this personality disorder’s profile. It’s unlikely that schizoid individuals, according to the findings, will try to exploit you.

Schizotypal. Individuals with this personality disorder score high on all three of the above traits — namely, vindictive, cold, and avoidant. This profile fits with the disorder’s main criterion of odd, eccentric, and socially awkward behavior.

Antisocial. The extreme of the psychopathic personality, people with this disorder scored high on the traits of domineering, vindictive, and intrusive, with slightly high scores on coldness.

Borderline. A broad set of interpersonal traits appeared in the studies of people with borderline personality disorder, but the highest scores were on vindictive and intrusive. You might experience this when with someone who has this disorder, particularly when you feel that your boundaries are being violated and you’re being held accountable to an extreme degree for your behaviors and possible shortcomings.

Histrionic. This personality disorder is rarely diagnosed, and was almost eliminated in the new DSM. However, the interpersonal trait profile showed distinctly high scores on domineering and, particularly, intrusiveness. These individuals are unlikely, in contrast, to be cold and socially avoidant.

Narcissistic. Remarkably similar to antisocial in the interpersonal style model, individuals with this personality disorder were also high in domineering, vindictive, cold, and intrusive interpersonal style traits. These qualities are ones that you’ll almost invariably encounter when dealing with people who fit this diagnostic category.

Avoidant. As you might expect, people high in avoidant personality disorder are most likely to be high on coldness and social avoidance, but low on domineering and intrusiveness. As the avoidant personality disorder is so aptly described in terms of interpersonal relationships, it makes sense that the profile as revealed in research fits this pattern.

Dependent. The dependent personality disorder showed a pattern of scores marked by the highest scores on intrusiveness and lowest, as you might expect, on domineering. Individuals with this disorder, who have an excessive need to be taken care of, readily submit to others. Their second highest score was on vindictiveness, but they were also high on exploitativeness.

Obsessive-compulsive. There were no stand-out features of this personality disorder in the overall analysis, which yielded a relatively flat profile across the eight traits. This finding suggests that perhaps this personality disorder doesn’t involve as much interpersonal dysfunction as has been thought, although individuals who fit the criteria of excessive perfectionism, inflexibility, and restricted expression of emotions may have trouble at work or in relationships. They may also, however, achieve higher status and wealth, as other research has indicated. There’s a trade-off, then, when an individual has such an extreme work ethic that he or she may pay less attention to relationships.

Summarizing the findings, the authors concluded that, without question, the “personality disorders are associated with dysfunctional interpersonal styles” and “core disturbances in self” (p. 720). From a diagnostic point of view, the authors also believe that the idea of discarding the personality disorder categories and replacing them with a rating system also receives support from their findings. All but obsessive-compulsive personality disorder appeared to have impaired interpersonal relationships, which in some of the analyses were particularly strong for family and less so for romantic domains.

There is still much to be learned about personality disorders, as the authors note. However, these findings suggest that cutting to the core of relationship difficulties and disturbances in sense of self provides the best way of understanding people who seem to fit the personality disorder definition. You don’t need to become a diagnostician to be able to use these findings in your daily life. Looking at people who may be narcissistic or psychopathic in terms of their interpersonal style rather than discrete categories provides perhaps a more realistic, if not sympathetic, way of relating to them.

Wow, thanks for taking the time to summarize these fascinating new findings! Relationships are what bring meaning to most of us, so they have the power to both heal and destroy. It is so important to know when it really is someone else’s stuff making the relationship unfulfilling or painful and not something that we are or are not doing right. These give us guidelines to consider when reviewing the relationships we have with others.

Psychology 101: When you can't understand something, break it down into classifications.

This gives the appearance of understanding while not actually saying anything useful. All you are doing is categorizing "interpersonal styles" instead of discrete categories. You also contract what you said in an earlier piece, about being more sympathetic.

That's our crappy mental health system for you. If you want helpful techniques to make people peaceful you'll have to seek out good quality Hindu yogis or Buddhist masters and then be willing to do lots of inner work. Most people are too lazy for that and just want pills to numb them.

I’m afraid I don’t agree with this new method of analyzing personality disorders, it doesn’t cover the full range of the traits and behaviors of each Pd.

For example, there is no mention of the extreme and inappropriate rage associated with Borderline Pd and Narcissistic Pd. Or the rapid mood swings and temporary psychotic breaks of Borderline Pd. Or the sexual acting out associated with histrionic Pd.

The new model is too limited, in my opinion.

A personality disorder diagnostic tool should be more like a menu that allows for a very individual, personalized selection of traits, in my opinion, and each trait designated as mild, moderate or severe in frequency and intensity.

I have to agree. This strikes me as something people could easily misuse by boxing certain traits of the disorder and ONLY focusing on those traits instead of noting the variables and things that are distinct to the individual. While labels and categories have their place this is too generalized and limited.

well, you just described about 90 percent of the population. Throw in there a few normal emotions and reactions, whether understandable or not, and then we have 100 percent. At least we keep the mental health field rich by hundreds of diagnoses that is for every simple, negative trait.

What a judgemental and simplistic mistaken view of life and your patients. This is exactly why people cannot trust this industry. Who in their right minds call their own patients vindinctive. A sad state of affairs and I have utter sadness about this. Professionals? Advanced? Leaders? Geez. We are in trouble if this is the best you got!

Nowhere in the article was anyone called or referred to as vindictive; rather, the term was used solely to signify the concept as a TRAIT.

'Emergence' holds that individuals are not defined as traits, ergo the whole is greater than the sum of parts--even when, (gasp!) pathology is involved. If you care to name any literature that argues otherwise, I'm all ears.

I have one of these disorders so perhaps it is safe to say that this article is not meant for me, as it seems that the victims in mental health are the ones who are exposed to me and others with the actual illness. So I probably should not even have commented in the first place. It is difficult not to take things personally when I am on the receiving end. It is no wonder we cannot seek help because help is available only to "our victims". I believe the industry lacks empathy. But perhaps the world would see that as my vindictive side.

I understand where you are coming from. Psychology today is really screwed up. It seems like it’s all about keeping the majority of the population from getting their feelings hurt, and the result is adults who never really become mature. We just keep limiting ourselves and our potentials because it’s so completely terrible to hurt another’s feelings. I think it’s all backwards. Your feelings get hurt because you believe something that isn’t true, that’s all. You take it personally.
I do not have a pd, myself, but my boyfriend does and I have learned so much about maturity, love, and breaking down my conditioning from being with him and keeping an interest in what is real and true.
I wish psychologists would be more interested in how our society is tremendously trained to be affected by each other, emotionally, and instead teach ways to become free from that conditioning.
Nothing is wrong with people who have a pd, we would be in a much better place as a society if we stopped labeling people at all and started to be responsible for our reactions.

Yes, yes yes, now this engagement and conversation on PDs and on human interaction has become a blessing. Real people are so wise. So touched and grateful. @Alex so much respect to you! @Bradley big support & respect to you! I feel like we are then creating beautiful waves in this whole thing, despite the mess ups of the systems and powers that appear to be. So thankful. 2.50am gratitude :-) Feeling like we can do this strange thing called life.

I am diagnosed with BPD and also have read extensively about the dx. I also have worked in the mental health field. I have long been saddened by professionals lack of compassion for people who have these disorders even for those of us who work every day to be higher functioning especially with friends and family. What also concerns me is the idea that people with personality disorders act out against people who are assumed to be normal and then they would be thought manipulative. My spouse is very manipulative t I've towards me. I didn't even want to recognize the ways in which his frequent dishonesty affected my ability to stay within a stable scheme of reality. Now I'm looking at this article and seeing that trying to express how his behavior affects me is actually pathological on my part according to this classification scheme. It would be great to believe that the people who treat the mentally ill would actually be our advocates. I don't mean enablers but shouldn't we be given the benefit of the doubt that we do what we do in spite of our desires to be healthy? It's lonely enough out here!

At Kez Daniel I'm a divorce attorney and believe me the nicest people can become unbelievably vindictive under certain circumstances so I think people have the capacity to be vindictive patients or otherwise

As a 48 year old woman who was diagnosed in 2012 with BPD, I think it's fair to say that humans in general, not only those suffering from a mental health condition, have the capacity to be 'vindictive', or any other trait found in the human condition. When I was first diagnosed I read everything about BPD I could get my hands on. However, when I found literature that described BPD sufferers as manipulative and controlling, I felt worse about myself than ever before. Now, after 2 years of therapy, I see that I was missing the point. Certain conditions would further dent my already fragile sense of self and, out of sheer self protection, I would act using the old patterns of behaviour that were familiar and safe. However, I didn't consciously think to myself: (eg) "I am going to punish you for that!" So, would I have described myself as a vindictive person? Absolutely not. However, would I have said that some of my behaviours when reacting to others have been vindictive? Yes I would. The reactions of a BPD sufferer (or anyone that is not very self-aware) are often lightening speed. That is why there are therapies like CBT which help people change their style of relating. I believe that the connotations associated with words like 'victim' 'persecutor' 'vindictive' 'controlling' 'etc. can discourage someone who already feels bad about themselves to seek help or continue with therapy, but I would like to say that anyone who is diagnosed with a PD or anything else related to mental health, try to be compassionate with yourself. We are all doing the best we can. I would like to add that, I don't actually think BPD fits my relating style at present, I'm more DPD. Whether that's an improvement in my relating style, I'm not sure, but my anxious episodes are less these days. Blessings to you all.

@Kimmy, Thank you. The weight of the negative publicity and images of PDs are just what you say - highly discouraging to people who are desperate for help. I believe that people with such issues seem to have a great(er) capacity for development and change, because you (we) are able to see when our behaviours have been so human and so hurtful sometimes, without our intentions having been bad. We are able to be extremely remorseful & sincere in our realisations of our styles, ways, errors, and are able to hold ourselves accountable and make the huge effort to look in that mirror and make changes in our lives to the extent that we no longer behave in a hurtful way. However, I have not had this experience from people without PDs, they behave in hurtful ways & they are stand by these ways as part of their permanent way of being, showing what could perhaps be a lack of interest in developing or improving behaviour that harms others. It is a paradox to me and it saddens me greatly that there is great loss, real loss, that self hate that comes about or grows from these images that are projected about people with PDs. I cannot help be very angry. It is quite interesting to me that BPDs are accused of black/white thinking & yet it is infact the industry & society that seems to reinforce this thinking of good/bad black/white and in some cases perhaps creates it. The whole industry is very sad, to me, thats how I feel about it, I have lost my respect for this industry, I have just seen too much suffering, the torment of people calling other people hopeless, in other words. I also find it interesting that most of these articles do not point out the other sides of the coin, as comes with any of these issues, a little one sided. I wish you all the best.

I feel for myself, things can land on more of a spectrum than a black and white diagnosis. I have a multiple diagnoses, the most prevalent being Complex PTSD, with DPD and BPD traits coming after that. I believe my mom and her mother were BPD, while my dad was very avoidant and co-dependent and grew up feeling unloved. On top of that, I was raised in a cult, and had a lot of health issues that caused PTSD. After a series of traumatic events when I turned 30, I was extremely triggered, and began seeking psychiatric help when I could barely function and had to go on sick leave from my job. At first they said I was depressed and anxious, so I went through CBT, which was ok but didn't begin to touch on many other issues. Later through my own research I demanded to be tested for BPD and PTSD and took the DSM-IV, which only showed DPD. Through that same referral, I saw a BPD psychiatrist months after the test, and he said yes, I did have BPD and PTSD. The program I'm taking wouldn't accept me at first because they said I needed PTSD treatment and wasn't crazy enough for BPD. I was finally accepted a year later, after they realized most people with BPD have PTSD too and trained their therapists to treat it. After I finish the DBT modules for a second time, I will begin Exposure Therapy. DBT is helping, but ironically, I know am too dependent on my BF to follow all the skills I need to implement. What I think I really need to be treated for is my attachment issues, but I don't know where to begin on that. Thankfully, my therapist specializes in C-PTSD as well as BPD. My sense of self has always been fragmented, but for what I can remember, I really do feel guilty for the way I've behaved over the years, and am so embarrassed to be mentally ill. In some ways, I was better off before I gained the skill of self introspection. I've felt more and more dissociated since being on medications and my past constantly haunting me through treatment. I honestly do want to recover, and want to stop feeling this way, but I have other things working against me. Even if I had better control of my emotions, I don't know how I can stop dating jerks and not feel alone and abandoned by my family, or like an outsider. I am not interested in looking for the new age "divine inside" either, as I am a Christian, but even religion can only go so far here. I pray my 40's will be much better and I will regain some cognitive function I've lost due to PTSD and get out of this emotional state I've been trapped in for almost 10 years.

Dear Tiffany, I feel for you. I don't know what to say to you but I couldn't not say something. I hear you and I hope that helps in some small way. Sometimes, it does help to know that others can understand, or empathize. Know that you deserve to have a beautiful future. Know that you did not deserve the trauma and pain from the past. Know that you have every right to be here, to feel your pain, to heal from your pain. Know also, that pain is part of life, and birth pains are part of giving birth to new life. I pray that your last 10 years may bring new life to you in these next ten and beyond. I have found the research of Prof. K. Dabrowski on his Positive Disintegration Theory a huge blessing. He talks about us breaking down, in order to create a new and higher state of reality, a new and better identity. I believe we are growing. Prof. Dabrowski says this is mental health, mental growth, not illness. It is a whole new way of looking at it, when you can have respect for the process in this way. It is not easy. I do not have any answers. I have hope. Somehow. In a hopeless world, I have hope, when I hear that others FEEL. Because the world needs a pulse, a heart beat. Attachment brings comfort, dare I say, I love the comfort of attachment. what if the attachments may be healthy and blessed, and grow in love. what if we needn't even say what is wrong with us, but what is right with us. What if we said, oh my, look at the love I am capable of giving, sharing. look at the deep connections I am able to have, look at how human I can be, and how I can admit to needing another. Who doesn't need anyone? we are here together, in a strange life, strange and beautifully we depend on each other in an entire eco-system of life. I hope you feel better soon. I hope I have not been intrusive in any way. I have a great respect for the bravery and honesty shown in your post. I feel for you. All the best. May you succeed and become the Oak Tree, that is inside your acorn, inside You.

Silly. Like an astrological chart but all negative. The father of all of this foolery built an elaborate justification for incest, and child rape among the “upper” classes; that’s been the basis ever since.

People are way too complicated to assign them an exact type.
Yes, diagnose a person as having a personality disorder, and leave it at that. My therapist refused to attempt to choose which type I have. Very wise was she. I have caught myself acting in ways that could be included in most of the mentioned traits. There are too many variables. We are all aware that life isn't fair. Our ability to cope with or consciously accept that reality may change from hour to hour.

I am not in the medical field and have not been diagnosed with these particular issues. However, I do have experience with a different mental illness diagnosis, and struggled for years with medication and with adjustment to the diagnosis itself.

First, I would like to encourage those going through treatment, introspection and change to be persistent in taking care of themselves. It's hard. Medications have side effects, it's difficult to know when dosages are right, and it takes time for our bodies to adjust to new regimens. In addition, it is difficult to process the very idea of making adjustments to old ways of thinking, especially when there is fear of stigma that we ourselves may have internalized (including fear of rejection, fear of new situations, and so on). Yet, please find what works well for you, because there are times in the future that can be much, much better than the difficult-to-work-through past and present. Persisting through the tough times is worth it. In my case, I had to go back to an older medication that worked better than newer ones. My body adjusted faster to it, the second time around, with fewer side effects. It also helped to have a medical professional tell me point blank, that I could still get married, despite the diagnosis. I needed to hear that, and it was true.

Second, I wonder how different cultures -- including microcultures within our country, not to mention cultures around the world -- tie into people's behaviors and responses. What seems maladaptive to a general culture might be seen as the norm in another context. It's not just individual responses that are hard to change, but traits that have developed that might have been inculcated in a given family or social structure. It can be challenging to stretch to a newer behavior pattern that fits the so called norm. Yet that change can make day to day life easier.

Third, I hope for the day when neurological markers are more advanced, and to see if they can help people with diagnoses that are subtle. It would be nice if mental health issues had more concrete markers than behavioral traits, which are often prone to be confused and blurred between different diagnoses. I hope we can have more basic research that could put some of the painful times people experience into more of a specifically treatable category. Just like advances in cancer research, this might help dispel some of the myths and some of the painful realities associated with difficult diagnoses and misdiagnoses.

Finally, brains do change, bodies adjust, and introspection and the help of others can bear fruit. We can learn to do our best with who we are, remembering that even people who are not diagnosed as being "mentally ill' still go through difficult periods in their lives, work and relationships. Anguish is real, but so is the fact that there are people around the world who wish the best and the most genuinely sustaining outcomes for everyone. We are part of that web. Wishing everyone a good holiday season ahead.

Personality itself is a disorder from the point of view of all meditative traditions for all of recorded history.Most of the behaviors called "personality" are a sad compromise between: our animal propensities;,trying to both obey and avoid all the does and dont our parents,teachers,priests and politicians inflict on us;,the small voice of our authentic inner nature;,and the call of the divine to transcend the cyclical prison of birth and death.
There is no normal personality,only degrees of deviation from the average suffering that most of us endure.I have been a psychiatrist for 60 years and a meditator for 50 years.Witnessing your personality indifferently is the time honored method for transcending it,all else is the left hand fighting the right.

However, the article title was very contradicting with the body message. I like the tone of the article though, it seemed as if it was based on a real study giving it validity. However, the one thing I didn't like was the suggestion of a finding but just giving more understanding of the disorders.